ABSTRACT
Of the 67 patients who were diagnosed with malignant histiocytosis at the Department of Medicine, Chulalongkorn Hospital, from January 1981 to May 1992, seven (10%) were found to have neurological manifestations. In five patients, neurologic diseases were the presenting clinical features. In the remaining two patients, the disease manifested at the time of relapse. Leptomeningeal infiltration, the most common pattern of involvement, was found in five patients. Involvement of the spinal cord was noted in three patients and cerebral parenchyma in two individuals. Two patients demonstrated peripheral neuropathy. Rapid clinical deterioration was observed in all patients after documentation of neurological diseases with a mean survival of 1.8 months. It is concluded that the frequency and pattern of neurological manifestations in patients with malignant histiocytosis are comparable to patients with non-Hodgkin's lymphoma. However, most patients with malignant histiocytosis manifested the neurological symptoms as an initial presentation while in non-Hodgkin's lymphoma, neurologic diseases usually manifest at the time of relapse or disease progression.
Subject(s)
Adult , Central Nervous System Diseases/diagnosis , Fatal Outcome , Female , Histiocytic Sarcoma/complications , Humans , Male , Middle Aged , Survival Analysis , Treatment OutcomeSubject(s)
Child , Histiocytic Sarcoma/complications , Humans , Jaundice/etiology , Male , Splenomegaly/etiologyABSTRACT
A human case of intestinal metagonimiasis that was incidentally found during the histological examination of a resected segment of jejunum was described. The small adults trematode of Metagonimus yokogawai were found free in jejunal lumen as well as impacted in intervillous spaces. Histologically intestinal lesions were massive lymphoplasmacytic and eosinophilic infiltration in stroma, erosion of neanby enterocytes, goblet cell depletion and occasional villous edema. Scanning electron microscopy revealed the worm of spatulate appearance with rake-shaped tegumental spines. By transmission electron microscopy, the syncytial integument with dense discoidal bodies, basement membrane muscle cells and subtegumental cells were observed. Characteristic junctional complex was demonstrated between subtegumental and parenchymal cells as well as between parenchymal cells.
Subject(s)
Adult , Animals , Humans , Male , Heterophyidae , Histiocytic Sarcoma/complications , Intestines/microbiology , Microscopy, Electron, Scanning , Trematode Infections/complicationsABSTRACT
A case of histiocytic medullary reticulosis with splenic infaraction from a 23-year-old male is presented. Radiologic findings on selective spleen scintigraphy and abdominal CT are described. Selective spleen scintigraphy showed huge, multilobulated spleen with numerous photon-deficient areas in it and peripherally. Abdominal CT showed large peripheral band-like low density and infiltrative lesion in spleen with accompanying intraabdominal lymphadenopathy. Histoligical features were consistent with HMR in spleen and liver specimens.